Provider Demographics
NPI:1063531192
Name:PSYCHOLOGICAL SERVICES FOR FAMILIES
Entity type:Organization
Organization Name:PSYCHOLOGICAL SERVICES FOR FAMILIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS, PH.D.
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:805-278-1997
Mailing Address - Street 1:PO BOX 1133
Mailing Address - Street 2:
Mailing Address - City:OAK VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:93022-1133
Mailing Address - Country:US
Mailing Address - Phone:805-278-1997
Mailing Address - Fax:805-278-2295
Practice Address - Street 1:500 E ESPLANADE DR
Practice Address - Street 2:SUITE 860
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2110
Practice Address - Country:US
Practice Address - Phone:805-278-1997
Practice Address - Fax:805-278-2295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12171103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY121710Medicaid
CACP12171Medicare UPIN
CACP12171Medicare ID - Type Unspecified